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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: /70.3- o 410 RECi- Building Permit Application MAR 2 0 2011 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓ PERMIT APPLICATION FOR: �' C L PROPOSED IN�PR,O�/EM�ENI" LD:CATIO�N: rrAA Address: Q, vl�' y Legal Description: Property Tax ID#: 12eQ CP d l• 0 0) 6- 0 0 0 Lot No. Site Plan Name: Block No. Project Name: uu C-0 _ nc,. Setbacks Front Back: Right Side: Left Side: D£TAILE© ©E�SCR�I�PTION O WORK: EM AeLr` 2 5FE or qi=r f (rqtr CQF` g V f PV- deycA le CONSTRIJC«TIO'N IN�F®'R�M�' TION°: Additional work to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 37 00 Utilities: —Sewer _Septic Building Height: 04 WIN I . 4 n � a �. Name aG�111 "Na'meSt' =` Address ]-�1� .[ S �r[ti g)Ifol Company a'l tm0'� City: lc72._ State: L_. Address:- .1 �( .� , Zip Code: `��cl Sf' Fax: City: j"Lt rt State: �L Phone No. Zip Code: Fax: E-Mail: Phone No /s�T j OP55 Fill in fee simple Title Holder on next page (if different E-MailG1vly ie- e-ri _c(fK Com ,from the Owner listed above) State or County License COC 015255 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ny �- SU�P'PLE11lI�ENT�4L C®NS1"R'UC1"I®N LI=NlF®.RMATL®0N�: �< DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made'to obtain a-permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen,rooms and accessory uses.to another n'on-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement rnust.be recorded a,nd posted on the jobsite before the first inspection. If you intend to obtain•financing, consult with lender.-or an attorney before commencing work or recording our Notice of Commencement. Signature o Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ) - STATE OF FLORIDA ' COUNTY OF 1, c ie, COUNTY OF Ss�= L(tC-le_' The for oing instrument was acknowledged before me The forgoing instrum t was acknowledged before me this'I day of �LbiTc.(�rrlq , 201-1 by this 1' day of 20J-1 by lenxr�lt ev (Name of person acknowledging) (Name of person acknowledging) 4, 2L= - 2�' (Signa re of Not r lic-State of Florida) (Sig a of Notar P blies-State of Florida) Personally Known Z" OR Produced Identification Personally.Known �� OR Produced Identification Type of Identification JENNIFER SMITH I yl a of Identification JENNIFER SMITH Produced COMMISSION 0 FF98466 J Pr duced MMISSION#FF984666 PP�� EMPIRES May 14,2020 PUB of pp�I May 14,2020 Commission No. FLORIDA (Seal)BONDED THROUGH CO mission NO. IDA WEDTHROUGH RLI INSURANCE COMPANY RU INSURANCE COMPANY REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.